A previous study displayed that the sensitivity of GenoType MTBDR plus for detection of MTB increased as the smear grade increased, reflecting an association between assay sensitivity and sputum bacillary burden.

Cats associated with cat-scratch disease are highly likely to be bacteremic with Bartonella henselae; however, even 28% of cats without known associations to cat-scratch disease or bacillary angiomatosis have Bartonella henselae bacteremia [7].

sup][2] We feel, the initial smear negativity in our patient could be due to dilution of sputum by secondary bacterial infection or the initial bacillary concentration was below the detectable limit for smear microscopy.

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